a free resource sponsored by the

1. The Hospital’s New “Home Team” How Hospitalists Can Help Shape the Emerging Medical Staff Model a free resource sponsored by the Practice Administrators' Roundtable Series X February 9, 2012

2. Presenters Jasen W. Gundersen, M.D., MBA, CPE, SFHM President & Chief Medical Officer TeamHealth Hospital Medicine Mark Sey, Pharm.D., MBA Vice President & Chief Administrative Officer Lodi Memorial Hospital

3. The Hospital Medicine “Drivers” • Care for the uninsured • Provider preference for employment models • Improve costs / length of stay • “Demand” from other providers • Co-management of surgical patients • Quality / Patient Safety • Hospital initiatives • Electronic Health Record • Avoiding unnecessary readmissions • Bundled payments

4. The Unintended Consequences • Provider passive separation from the Hospital • Active separation by directly competing with Hospital • Provider disillusion with Hospital “change” • Reduction in focus within Medical Staff Departments

5. Medical Staff Bylaws • Complicating the evolutionary changes of traditional Medical Staff models • Changing or altering the bylaws is not easy • May not be in sync with current practice patterns • Affect on the ‘new medical staff’ • More time demands on limited providers • The role of the EMR • Staff Categories • Maintaining synchronization with hospital administration

6. Polling Question • Do your medical staff bylaws have a staff category for outpatient only providers? • Yes • No • Currently developing a new category • Unsure

7. Planning for the Future • Community provider involvement remains CRITICAL • Care transition programs • Role in admission/readmission management • Improving ambulatory care sensitive admissions • Develop new staff categories • Maintain ‘active’ role • Maintain relationships between inpatient & outpatient providers • Quarterly Meetings • Newsletters

8. Hospital MedicineShaping New Medical Staff Models • Department or Division • Depends on size of program • Credentialing/Delineation of Privileges • Assure current with practice patterns • Block scheduling and provider participation • Supporting committee work and development • The high cost of turnover • Individual vs. Group • A ‘problem’ for the specialty

9. Hospital MedicineShaping New Medical Staff Models • Hospital Medicine physician engagement • Varying levels of commitment • Identifying areas of interest • Encouraging program/project “ownership” • Shaping more than the Medical Staff • Compensation • Direct • Workload reductions

10. Polling Question • Hospital Medicine physicians fulfilling Medical Staff leadership responsibilities are a difficult commitment and burdensome. • Agree • Somewhat agree • Disagree • Unsure

11. Thank you for your time today